DOI: https://doi.org/10.36347/sasjm.2026.v12i02.011

Pages: 128-134

Introduction: Seasonal malaria chemoprevention [SMC] is a key malaria control strategy in Mali targeting children aged 3–59 months and has been extended to children aged 59–120 months in four health districts of the Sikasso region. However, implementation gaps have been reported, potentially affecting adherence to the treatment regimen. This implementation research aimed to identify barriers to SMC adherence in the Selingué Health District and to propose actionable recommendations. Methods: A qualitative study was conducted in September 2023 using semi-structured interviews with SMC implementers and focus group discussions involving community leaders, health workers, and community health volunteers. Data were audio-recorded, transcribed, and analyzed thematically. Outcome: Barriers to adherence were identified across three domains: [i] organizational, including misalignment of the campaign period, lack of supervision of follow-up doses, and limited communication strategies; [ii] socio-cultural, including household decision-making dynamics, strong maternal involvement with limited paternal support, and competing agricultural activities; and [iii] trust-related, including mistrust of health workers and medicines driven by rumors. Conclusion: Strengthening adherence to SMC requires improved, context-sensitive communication, trusted community-based actors, and enhanced supervision of follow-up doses. Meaningful community engagement is critical to address misconceptions and sustain adherence.